SUBJECT : Shalya Samanya
15.SHALYA - SAMANYA
Theory- 100 marks
Practical and Viva-voce - 100 marks
Part A (50 Marks)
Basic principles of Kshara Evum Anushastra Karma
- Etymology and definition of Shalya Tantra.
- Scope and Importance of Shalya Tantra.
- Study of Sushrut Samhita Sutra Sthana 1- 46 chapters.
- Study of Modern surgical clinical methodology.
- Applied anatomy , physiology and surgical pathology of common surgical conditions including relevant Ayurvedic aspect.
- Applicability of Shat-kriya Kaal in the pathogenesis of surgical diseases.
- Applicability of Prakriti in understanding the causes and role of treatment in surgical diseases.
- Applicability of basic principles of Ayurved in Rogi Pariksha (Trividha, Shadvidha, Ashtavidha and Dashavidha Pariksha) and latest investigations.
- Concept of Rakta according to Sushruta.
- Introduction of clinical and diagnostic methods in Shalya Tantra - X-rays, U.S.G., Endoscopes (for diagnostic and treatment purposes), MRI, CAT scanning and other recent diagnostic tools.
- Concept and applicability of Sadhya-Asadhya- Prognosis – aristha lakshna
- Knowledge of Life saving drugs.
- Emergency conditions and its management.
- Diagnosis and management of Pranastha Shalya
Part B (50 Marks)
Applied aspects of Kshara Evum Anushastra Karma
- Kshara Karma – Introduction, types, method of various preparations like Kshara, Kshara Varti, Kshara Pichu etc. and applications.
- Kshara Sutra – Method of preparation, Standardization and applications.
- Agni Karma – Introduction, types and applications.
- Raktamokshana – Introduction, types and applications.
- Yantra and Shastra – Ancient and recent.
- Concept of Trividha Karma – Purva, Pradhan and Paschat.
- Ashtavidha Shastra Karmas.
- Basic knowledge of Sanghyaaharn – Anaesthesia, types, methods,
Indications, contraindications, complications and its management.
- Sterilization – Methods and types.
- Bandhana Karma – Ancient and recent.
- Application of panchakarma therapy in surgical practice
- Scope of pathya- apathy in the management of surgical diseases
Pattern of Practical examination 100 Marks
- Case Record (25) -10 Marks
- Bed side examination
- Short case -10 Marks
- Long case -25 Marks
- Identification of specimen / radiograph and Instruments -25 Marks
Viva-voce -30 Marks
The goal of postgraduate medical education shall be to produce competent surgical specialists and teachers.-
i. who shall recognize the health needs of the community, and carry out
professional obligations ethically and in keeping with the objectives of the
national health policy
ii. who shall have mastered most of the competencies, pertaining to the surgical
speciality, that are required to be practiced at the secondary and the tertiary
levels of the health care delivery system;
iii. who shall be aware of the contemporary advance and developments in the
iv. who shall have acquired a spirit of scientific inquiry and is oriented to the
Principles of research methodology and epidemiology; and
v. who shall have acquired the basic skills in teaching of the medical and
15. SHALYA - SAMANYA
PAPER - I
Shalya Siddhanta – Fundamentals of Surgery
- Dosha, Dhatu and Mala Vigyan and there importane in surgical diseases
- Significance and importance of Rakta as the fourth Dosha.
- Yantras and Shastras – ancient and recent.
- Trividha Karma – Purva, Pradhan and Pashchat Karma. Importance of trividha karma.
- Asepsis and Antisepsis.
- Nirjantukarana – Sterilization – Methods, Types in special surgical equipments and operation theater.
- Surgical infections – Sepsis, tetanus and gasgangreen
- Care of patients suffering from hepatitis, HIV-AIDS etc.
- Ashtavidha Shastra Karma – Critical knowledge and their application in surgical practice.
- Suturing materials, appropriate use of sutures, drains, prosthetic, grafts and surgical impalnts.
- Concept of Marma in Shalya Tantra.
- Concept of shock - Its varieties and management.
- Rakta srava - Types and clinical features. Concept of Raktastambhana –Haemostasis.
- Vranasopha, Vidradhi and Prameha Pidaka.
- Granth and Arbuda – benign and malignant neoplasia – concept of oncogenesis and genetics of cancer
- Gulma and Udararog
- Kshudra Rog – actinomycosis, syphilis, leprosy and Madura foot diseases.
- Fluid, electrolyte, Acid Base Balance and Nutrition
- Introduction to physiology of fluids and electrolytes
- Dehydration and over hydration,
- Specific electrolyte losses and symptomatology and management of Acidosis, Alkalosis and Acid base balance.
- Electrolyte changes are specific surgical conditions and their management.
- Plasma volume expanders and their use in surgical conditions.
- Various replacement fluids in surgery, mode of administration and complications.
- Parenteral Nutrition – indications, types, mode of administration and complications.
- Blood Transfusion – Indications, blood groups, components, compatibility and complications with management. CVP, blood products, acute adrenal insufficiency, hyperbaric oxygen and bleeding disorders
- Knowledge of antibiotics, analgesics, anti-inflammatory and emergency drugs in surgical practice.
PAPER - II
Vishishta Shalya Karma Abahyas(Experimental and practical training of Surgery)
- Yogya - Practical and Experimental training
- Practice of surgical procedures on different models.
- Description of Yogya mentioned in texts.
- Specific knowledge of surgical procedures in different diseases.
- Vrana – Wound
- Management of Nija Vrana, Agantuja Vrana, Dushta Vrana and
Nadi Vrana. Infection of hands and foot.
- Vrana Chikitsa – Pathya-apathya and Shashti Upakramas
- Varieties and management of Dagdha Vrana - Burn and scalds.
Diabetic wound and its management
- Gangrene - management.
Mutra Rog – Urological diseases.
Anatomical and physiological knowledge of kidney, ureter,
Urinary bladder, prostate, seminal vesicles, urethra and penis.
Investigations of Mutravaha Srotas – urinary tract.
Knowledge of pathogenesis, causes and surgical
Procedures of Ashmari – urinary stone disesses.
Kidney and ureter – Clinical presentation, investigations and management of - congenital anomalies, Trauma, Infection, Neoplasia, hydronephrosis,hydroureter, Haematuria
Urinary bladder - Clinical presentation, investigations and management of - congenital anomalies, Trauma, Infection, Neoplasia, Diverticuli, atony, schistosomiosis,urinary diversions,
Urethra- Clinical presentation, investigations and management of - congenital anomalies, posterior urethral vulve, Trauma, Infection, Neoplasia
Retion of urine – Mutraghata, Mutrakruccha - causes investigation and management.
Renal failure – causes, diagnosis and management
Prostate and seminal vesicals – benign and malignant enlargement of prostate, prostatitis, prostatic abscess and calculi.
Penis – Congenital, phymosis and paraphymosis,traumatic, inflammatory and neoplastic peyronie’s disease, Forniers’gangreen
Testis and scrotum - - Clinical presentation, investigations and management of - congenital anomalies, ectopic testis, Trauma, Infection, Neoplasia, testicular torson, hydroc43ele, vericocele, spematocele, chilicele, pyocele, haematocele, epededymal cyst.
Asthi rog –Orthopaedics/Marma chikitsa.
Anatomy and physiology of bone.
Diseases of bone and joints – Infection, congenital, exogenous
diseases, generalized diseases, abscess, osteoporosis,
osteomyelitis, tumours of bones and chronic joint diseases. Joint replacement.
Upper and lower limb ischemia and gangrene- vatarakra
Aetiopathogenesis, treatment along with surgical procedures of
Bhagna - fracture, Sandimoksha - dislocation and bone
Diseases of Spine, vertebral column and spinal cord.
Sandhana Karma – Plastic reconstructive and cosmetic surgery.
Fundamentals of Sandhana Karma.
- Karna Sandhana – Earplasty
- Nasa Sandhana – Rhinoplasty
- Ostasandhana – Cheiloplasty
- Skin grafting
- Damani sira sandhan- vascular anastomosis and grafting.
- Anushalya Karma – Parasurgical procedures
- Kshara Karma, Kshara Sutra, Agnikarma and Raktamoskhana.
- Peripheral nerve diseases
PAPER - III
Modern surgery including surgical pathology
- Fundamentals of modern surgery and treatment of surgical disorders including surgical anatomy, physiology and pathology.
- Diagnosis and Surgical treatment of head and spine injury, thoracic trauma, and abdominal trauma. Blast injuries and management
- Diagnosis and Surgical management of neck disorders e.g. salivary glands, thyroid,thyroglosal cust and fistula, branchal cyst and fistula, cystic hygroma, Lympadenopathies etc.
- Diagnosis and Surgical management of Benign breast diseases and breast tumours
- Diagnosis and surgical measures of diseases of Gastrointestinal system-
- Oral cavity- Oral ulcers, oral cancer,precancerous conditions, submucosal fibrosis, lekoplacia.Claft lip and cleft palate, lip tumours,Nasopharanxial cancer.Toung ulcer and cancer. Mucosal l cyst.
- Oesophagus- esophageal varices, dysphagia, neoplasia, strictures,abnormal gastro esophageal reflex
- Stomach and duodenum –Congenital anomalies, inflammation, ulcer, neoplasia, stenosis, acute dilatation, injuries, Foreign bodies, Haematemasis.
- Pancreas - Congenital anomalies, inflammation, acute and chronic pancreatitis, calculi neoplasia, pancreatic cyst and cystic fibrosis.
- Peritoneum, omentum, mesentery, retroperitoneal space – peritonitis, abscess, neoplasia.Laperatomy, mesenteric cyst, torson of mesentry, vascular thrombosis, retroperitoneal cyst ,abscess and fibrosis.
- small intestine -Congenital anomalies, inflammation, ulcer, neoplasia, stenosis, injuries, Foreign bodies, diverticuli,peutz jegher syndrome,chrons diseases,carcinoid tumours.Enteric perforation,intestinal fistula.
- large intestine and - Congenital anomalies, inflammation, ulcer, neoplasia, stenosis, injuries, Foreign bodies,divertica, faecal fistula, amebiosis,FAP, malaena
- Caecum vermiform appendix- appedecitis, appedecular abscess, appedecular masss perforation, carcinoid tumor, neoplasia
- Gastrointestinal bleeding – haetemasis, malaena, haemobelia, bleeding per anum - causes , diagnosis and management.
- Abdominal mass- diagnosis and management.
- Rectum and anal canal - Diagnosis and surgical management of Congenital anomalies, inflammation, ulcer, neoplasia, stenosis, prolaps, haemorroids,fistula, fissure, anorectal abscess, incontence, injuries, Foreign bodies, sacrocoxigial teratomas, pilonidal sinus .
- Umbilicus and abdominal wall – Congenital anomaly, umbilical infection, sinus, neoplasm. Abdominal dehiscence, Diverication of recti, Desmoid tumor, Meleny’s gangrene
- Diagnosis and surgical measures of diseases of Hepatobiliary system - liver, gall bladder, bile ducts and spleen and portal hypertension
Liver – abscess, Cyst- hydrated cyst, primary and secondary malignant tumours, Budcherry syndrome.
Gall blader and bile duct - Congenital anomalies, acute and chronic cholicystitis, cholitiasis,neoplasia, cholingitis, stenosis, cholidocholitiasis, cholidocho cyst, cholingio carcinoma, injuries. Spleeno megali, spleenic injury.
- Diagnosis and surgical measures for disorders of vein, artery, ligaments, joints and muscles.
- Diagnosis and surgical management of Hernias – Inguinal, femoral, umbilical, incisional, abdominal wall and other hernias.
- Endoscopic procedures - Gastroduodenoscopy, Sigmoidoscopy, Colonoscopy etc.
- Diagnostic and therapeutic laparoscopy.
- Anaesthesia - Definition, Types, anesthetic agents, indications, contraindications, procedures, complications and management.
Shalya Vangmaya – Shalya literature, research and development
- Thorough study of the text including portions of Brihat treya and Laghu treya related to surgical aspects.
- Medico legal issues - Understanding the implications of acts of omission and commission in practice. Issues regarding Consumer Protection Act, medical profession, national health policy - Implications in a medico-legal case like accidents, assaults etc.
- Surgical ethics including Informed consent.
Pattern of Practical Examination:-
- Case Record(25) -10 Marks
- Bed side examination
Short Case -10 Marks
Long Case -20 Marks
3. Identification of specimen / Instrument / Radiograph -20 Marks
4. Thesis Presentation -20 Marks
5. Viva Voce -20 Marks
- Sushrut Samhita with Dalhana Commentary
- Sushrut with Ghanekar Commentary
- Related matters of Astanga Sangraha, Astanga Hridaya, Madhava Nidan etc.
- The Surgical instruments of the Hindus – Girindranath Mukhopadhyaya.
- Shalya Tantra Samuchchaya – Pandit Ramadesh Sharma
- Shalya Vijyan (Part 1-2) – Dr. Surendra Kumar Sharma
- Shalya Samanvaya (Part 1-2) – Vd. Anantaram Sharma
- Shalya Pradipika – Dr. Mukund Swarup Verma
- Soushruti – Dr. Ram Nath Dwivedi
- Bhagna Chikitsa – Dr. Prabhakar Janardhan Deshpande
- Kshara sutra management in anorectal ailments – Dr. S.K. Sharma, Dr.K.R.Sharma and Dr. Kulwant singh
- Anorectal diseases in Ayurved – Dr.Sizoria and Dr. Praveen Kumar
- Adhunika Shalya Chikitsa Siddanta– Dr.Katil Narshingham Udupa
- Agnikarma Technology Inovation – Dr. P.D. Gupta
- Shalya tantra Ke Sidhant – Dr. K.K.Takral
- Surgical Ethics in Ayurved – Dr.G.D. Singhal
- Susruta’s Contribution to Surgery – Dr. S. Sankaran
- Recent advances in the mangement of Arshas / Haemorrhoids
– Dr. P. Hemantha Kumar
- Arsha Evum Bhagander Men Sutravacharan – Vd. Kanak Prasad Vyas.
- Kshara Sutra – Dr. S.N.Pathak
- Surgical ethics of Ayurved – Dr. S. Sankaran
- Anushastra Karma – Dr. D.N. Pande
- Concept of Vrana is Ayurved – Dr. Lakshman Singh
- Significance for Purva Karma in Surgical Patient – Dr. Lakshman Singh
- Text book of Surgery – Sabistan
- Operative Surgery – Rob and smith
- Fractures and Joint Injuries - Watson-Jones
- Text books of Operative Surgery - Farquharsons’
- Principles of Surgery - Schwartz
- Emergency Surgery -Hamilton Bailey’s
- Surgical pathology - Willing Worth
- Clinical methods in surgery – S. Das
- Methods of Surgical Procedure – S. Das
- Short practice of surgery - Bailey and love’s
- A concise text book of surgery – S. Das
- A manual on clinical surgery – S. Das
- A practical guide to operative surgery - S. Das
- Text book of Surgery – Surgeons Association of India
- Clinical Anatomy/ Surgical Anatomy – Snell
- Essential P.G. Surgeon – Filinge, Davice
- Outline of Orthopaedics – J.C.Adams
- Clinical orthopaedic diagnosis – Suresh Pandey
- Manipal manual of surgery -
- Shalya Shalakya tantra - Vd S G Joshi.